Beauchamp T L
The Kennedy Institute of Ethics, Georgetown University, Washington, DC 20057, USA.
J Med Philos. 2001 Dec;26(6):601-19. doi: 10.1076/jmep.26.6.601.2995.
What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Three influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal/external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each over reaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features.
医学伦理学中的结论基于何种依据且为何合理？其来源是医学外部还是内部？近期文献中出现了三种有影响力的答案类型：内部论、外部论以及内部/外部混合论。第一种观点捍卫一种源自医学目的或专业实践标准的伦理。第二种观点认为医学伦理学的戒律依赖于外部标准（如公众舆论、法律、宗教伦理或哲学伦理）并需要其进行辩护。第三种观点声称不同的医学伦理源自不同的文化框架，每个框架都有规范医生的准则。每种观点都有其价值，但每种都超越了其支持论据的范畴，且未能认识到其竞争对手观点中的合理之处。我提出第四种观点，它提供了一种方法来摆脱其他三种观点的局限，同时保留它们最吸引人的特征。
